Post-Operative Complications of Implant Placement

With the increasing acceptance of dental implants as a viable tooth replacement therapy, complications & failure rates have also increased proportionately.

A range of possible post-operative complications & their prevention are described below:

  1. Infection: Implants are made of titanium, which is strong & biocompatible, which means that is not rejected by the body. So the chances of developing post-operative infection are extremely rare. At times when dentist do not follow effective & strict protocol of sterilization, patient might be vulnerable to post operative infection.

Post-operative infection causes pain & discomfort to the patient, reason being- bacterial contamination of implant or surgical site during the procedure.

If the infection is limited to the soft tissue, a small gum boil will be noticed over the implant site. It can be punctured using a sharp probe & irrigated with chlorhexidine solution or citric acid. It heals & the pain subsides within 24hrs.                                                                                        In case of continuous pus discharge & severe pain which is not relieved by analgesics, this depicts that the infection has reached to the bone-implant body interface.

Prevention: one should follow strict protocol of sterilization in the operatory in order to avoid any bacterial contamination. Also, in such cases, the implant should be removed immediately & prescribe good antibiotic like tab Augmentin 1000mg twice a day for 5-7 days. A new implant can be inserted when the site gets healed in 6 weeks.

  1. Post-operative Edema: Post-operative edema develops in cases of traumatic implant placement. High speed drilling & no constant stream of chilled saline causes bone to overheat & this leads to accumulation of fluids in tissue spaces i.e. edema.

 

Prevention: Unnecessary trauma to the bone must be avoided during osteotomy preparation. Drilling speed must be set according to the density of bone along with a pumping motion of the drill should be employed during drilling to allow the saline to cool down the bone. This prevents overheating & necrosis of the bone.

Patient must be advised to apply an ice pack over the facial   skin of the surgical site intermittently for 45 min to cool down the bone in order to suppress heat generation & inflammatory oedema.

        prevention

  1. Pressure necrosis: results in cases where implant has been inserted & screwed at a very high torque, it may lead to pressure necrosis of the surrounding bone & the patient will complain of continuous pain not relieved by analgesics, for weeks after the surgery.

 

Prevention: Drilling at higher speed with maximum amount of chilled saline irrigation flow to cool down the bone. Use of final drill with the diameter only 0.2mm less than the implant diameter along with the use of bone tap to prepare threads in the bone to accommodate implant threads. Following these instructions help in reduction of post-operative pressure necrosis.

  1. Suture line opening: leads to exposure of implant threads in the oral environment & may cause the collection of plaque over the exposed rough surface of the implant, which may further cause peri-implantitis & loss of hard & soft tissue around the implant.

 

Causes of implant thread exposure

  • Suture line opening & loss of graft in cases where simultaneous bone grafting has been performed with implant placement also leads to implant exposure.
  • More superficial implant placement.
  • Thin mobile soft tissue recedes with muscle pull.

        Management:

  • Tension free sutures should be used to avoid the suture line opening because of the tension in the flap.
  • The open suture line should not be re-sutured but the patient should be instructed to keep it clean, as it heals by secondary intention in 2-3 weeks.
  • If soft tissue healing has not covered the exposed threads, either cover the threads using soft tissue grafting with or without simultaneous bone grafting, or adequate grinding & polishing should be done to make the surface smooth & prevent accumulation of plaque.

  1. Bone resorption: one of the most common complication in dental implantology. When occlusal forces are not distributed equally i.e. is off-axis to the implant prosthesis leads to resorption. Also, when implant with a wider platform is placed into the narrow crestal bone causes crestal bone resorption.

 

Prevention: Implant must be placed along the axis of the future prosthesis. For large mesio-distal diameter two implants should be placed with narrow occlusal table of prosthesis. Along with the maintenance of oral hygiene, soft tissue grafting for compromised soft tissue around the implant must be addressed.

  1. Peri-implantitis: is an inflammatory reaction with the loss of supporting bone in the tissues surrounding a functioning implant. Peri-implantitis is characterized by bleeding/suppuration on probing, together with loss of supporting bone.

The peri-implantitis lesion exhibits histopathological features that similar, but not identical, to those in periodontitis. Similar to periodontitis, the treatment of peri-implantitis must be based on infection control. Under these conditions, progression of the disease may be arrested & subsequent, lost peri-implant tissues may be generated by bone augmentation & soft tissue grafting procedures.

peri-implantitis

With this increasing trend of replacing the lost tooth with an implant, at Dr. Sachdeva’s Dental Institute, we incorporate several associated procedures like bone augmentation to provide this therapy to the maximum number of patients. We follow strict protocol for sterilization & restore implants to minimize postoperative or post loading complications.

“Aesthetic Dentistry Is The Art Of Dentistry In Its Purest Form”

Dentofacial Attractiveness

  • An attractive smile has always been the focal point of attention.
  • Esthetic dentistry seeks not only to improve the Esthetic appearance, but to improve the patient’s self-esteem and it should not be underestimated.
  • A display of pleasing intact dentition is the key element in the creation of an attractive smile.
  • As it has been said “Better smiles are being equated with better living.”
  • A beautiful smile seems to reflect a style of living, and enchantment of facial beauty is why patients are seeking elective dental care.

 New concept of dentistry

Esthetic dentistry has opened an entirely new world for most clinicians and changed the lives of hundreds and thousands of patients in a very positive way.

 Esthetics and function

It is the esthetic dentist’s responsibility to produce treatment plan that is esthetically pleasing, functional as well as biocompatible.

 Natural looking restorations

Restoring the tooth and achieving the esthetic harmony by maintaining the natural morphological state of the tooth.

Surgical Treatments for Gum Diseases

Flap surgery/pocket reduction surgery: In this procedure the gums are lifted & calculus is removed. Irregular surfaces of bone are smoothened. The gums are then placed so that it fits snugly around the tooth. This reduces the size of the space between the gum & tooth, decreasing the areas where harmful bacteria can grow.

Bone grafts: involves using fragments of your own bone, synthetic bone to replace bone destroyed by gum disease. The grafts serve as a platform for the regrowth of bone, which restores stability of teeth.

Soft tissue grafts: This procedure reinforces thin gums or fills in places where gums have receded. Protect root surface from sensitivity, caries/abrasions & improves hygiene.

Depigmentation of dark gums: Pigmentation affects most of gum tissue with a complete brown appearance. The pigmentation can be completely removed surgically. Discomfort to the patient pre & post surgery is minimal.

Crown lengthening: is a surgical technique for gummy smile. It is a procedure performed to expose greater amount of tooth structure to restore prosthetically & esthetically. Appropriate crown margins can violate the requirements for periodontal health. An Inappropriate crown margin increases plaque accumulation in close proximity to bone crest.

Guided tissue regeneration: is a procedure in which a barrier membrane is placed under the gum & over the remaining bone. It is performed to stimulate growth when the bone supporting your teeth has been destroyed. A small piece of mesh-like fabric is inserted between the bone & gum tissue.

Bone surgery: modifies bone support altered by periodontal disease, either by reshaping the bone, without removal or by the removal of some alveolar bone.

Looking for treatment of periodontal disease?? 

                                 Find experts advice on periodontal disease treatment at                   

 Dr. Sachdeva’s Dental Institute. We believe in conservative approach for periodontal treatment.

LASERS IN PREVENTIVE DENTISTRY

  • Laser treatment is becoming widely recognised and can be applied to prevent caries from developing and to reduce the progression of caries.
  • The mechanism of laser should be understood before a dentist could apply in his daily practice.
  • The Enamel surface of tooth is made of crystals called ‘Hydroxyapetite’ and it is permeable in nature therefore allowing diffusion of ions.
  • During laser treatment, moderate heat(CO2 laser produces temp > 1000 degree celcius) is produced which changes the composition of Enamel from ‘hydroxyapetite’ to ‘carbonated apetite’ in which there is loss of water in the crystals, as a result the pores of Enamel shrink down to form ‘Microspace system’. The Microspace system provides a means for trapping Calcium, phosphate and fluoride ions which release during demineralization and acts as site for re-precipitation.
  • The trapped minerals phases inside the Enamel and impedes lesion formation and progression causing enhanced resistance against demineralization.
  • As the microspaces are smaller in size, it decreases the permeability of the Enamel thereby reducing the diffusion of ions in and out thereby reducing the demineralization process. Thus a seal is achieved and so is resistance to caries.
  • The Dentin also gets acid resistance as there is increased mineral content due to burning of organic matter from tissue so there is increased Calcium and Phosphate found in recrystallized Dentin.

If you want to consider being mentored by Dr Rajat Sachdeva contact him directly on 01142464041 for an informal chat.

Something You Must Know Before Any Dental Implant

A dental implant is an artificial tooth root that is placed by your surgeon into your jaw to hold a replacement tooth. Dental implants can be helpful option for people who have lost a tooth or teeth due to an injury or some periodontal disease.

Available Types Of Dental Implants:

There are two types of dental implants and you must have a brief knowledge about them before going for Low Cost Dental Implants.

Endosteal Dental Implants:

This is the most commonly used type of implant which actually goes inside the bone. The various types include screws, blades surgically placed into the bone of your jaw. Each implant holds one or more prosthetic teeth.

Sub periosteal Dental Implants:

These dental implants are placed on top of the jaw with the metal framework’s posts protruding through the gum holding the prosthesis teeth.

I would suggest for trying the services of Sachdeva Dental care instead of searching on Google. They are good in this work and even imparting training in several Dental Implant Courses.

Most of us also have this question before this kind of surgery. Am I a candidate for dental implant? Well, if you have lost your teeth then you are a candidate for this. Certainly good health is vital in this type of treatment too as there are few health conditions and diseases that can affect whether dental implants are right for you or not. If you are having uncontrolled diabetes, any sort of addiction, radiation to the jaws, uncontrolled periodontal disease and cancer may affect whether dental implants will fuse to your bone or not. Where and how such implants are placed requires a detailed assessment of your overall stomato-gnathic system within which the teeth function.componeers

This sort of surgery will yield to a great help for your smile if it is done by expert hands. I had shared about Best Dental Implant Delhi in this post. You should try them. Always remember, it is pretty necessary to let your dental surgeon know all about your past and present medical status along with all medications you are taking nowadays.

Reach us at +918527017175. We look forward to making you our next satisfied

We look forward to helping you upgrade your smile and your quality of life!

Dr. Rajat Sachdeva
Dr. Sachdeva’s Dental Aesthetic &Implant Centre
I – 101, Ashok Vihar,
New Delhi -110052
Mobile: +919818894041
Clinic: 011-42464041, +918527017175
http://www.sachdevadentalcare.com/